Although there is growing interest in applying benefit-cost analysis (BCA) to public policy questions, limited information is available on states’ use of this methodology. The nationwide assessment presented here begins to fill that void and finds that states and the District of Columbia are increasingly conducting BCAs and using the results to inform their policy choices. The numbers of reports released by the states and statutory mandates to conduct these studies increased substantially between 2008 and 2011. An analysis of the studies released by states shows that most lack some recommended technical features of rigorous BCA, but the reports are having a reported impact on state policy and budget decisions. Like other forms of policy research, BCA faces challenges including resource and data limitations, timing problems, and gaining policymaker buy-in for the approach and findings.